Struhelka, Jacob Edward

Struhelka, Jacob Edward is an individual health care provider with primary practice located at 3301 N Ballard Rd Ste B , Appleton WI 54911-9002. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Struhelka, Jacob Edward can be contacted via phone (920) 733-4443.

Contact Information

Primary practice address
3301 N Ballard Rd Ste B Appleton WI 54911-9002
Phone: (920) 733-4443
Fax: (920) 733-4796
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15257132 Wisconsin

Profile Details

NPI number 1881808533
LBN Legal business name Struhelka, Jacob Edward
Credentials CLINICAL SUBSTANCE A
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2007
Last updated Jul 10th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881808533 NPPES
Wisconsin MEDICAID 42018000

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